Badel Tomislav, Savić Pavičin Ivana, Krapac Ladislav, Zadravec Dijana, Rosić Davorka
Tomislav Badel, DMD, PhD, Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
Acta Dermatovenerol Croat. 2014;22(2):114-21.
In addition to psoriasis, between 5% and 24% of patients will develop psoriatic arthritis simultaneously after or even prior to skin manifestations. Psoriatic arthritis belongs to the group of seronegative spondyloarthritis. Collaboration between a dermatologist and a rheumatologist plays a more important role in cases where there is a complete absence of clinical signs of psoriasis. Since rheumatic diseases may also involve the temporomandibular joints (TMJ), psoriatic arthritis can cause problems that are an aspect of systemic disease. In general, the clinical and radiological description of a population of patients suffering from psoriasis and/or psoriatic arthritis does not mention TMJ involvement. However, as is the case with intraoral psoriasis, psoriatic changes to the TMJ also show characteristic signs of erosion, deplaned condyles, and articular effusion. Magnetic resonance imaging has shown itself to be the gold standard in the diagnostics of joints afflicted by psoriatic arthritis and TMJ disorders, regardless of the existence of a systemic disease. This paper aims to present a review of the relevant literature describing different epidemiological, clinical, and radiological characteristics of psoriasis and psoriatic arthritis, with emphasis on the involvement of TMJs in the general manifestation of the disease, illustrated by a description of the clinical case of a 77-year-old female patient.
除银屑病外,5%至24%的患者会在皮肤表现出现后甚至之前同时发生银屑病关节炎。银屑病关节炎属于血清阴性脊柱关节炎组。在完全没有银屑病临床体征的情况下,皮肤科医生和风湿病医生之间的合作起着更重要的作用。由于风湿性疾病也可能累及颞下颌关节(TMJ),银屑病关节炎可引发作为全身性疾病一部分的问题。一般来说,对银屑病和/或银屑病关节炎患者群体的临床和放射学描述并未提及TMJ受累情况。然而,与口腔内银屑病一样,TMJ的银屑病改变也表现出侵蚀、髁突表面平整和关节积液等特征性体征。磁共振成像已被证明是诊断受银屑病关节炎和TMJ疾病影响的关节的金标准,无论是否存在全身性疾病。本文旨在对描述银屑病和银屑病关节炎不同流行病学、临床和放射学特征的相关文献进行综述,重点关注TMJ在该疾病总体表现中的受累情况,并通过对一名77岁女性患者临床病例的描述加以说明。